Association of state and territorial public health nutrition directors june 2004
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Association of State and Territorial Public Health Nutrition Directors June, 2004

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Association of state and territorial public health nutrition directors june 2004

  • This presentation will probably involve audience discussion, which will create action items. Use PowerPoint to keep track of these action items during your presentation

  • In Slide Show, click on the right mouse button

  • Select “Meeting Minder”

  • Select the “Action Items” tab

  • Type in action items as they come up

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Association of State and Territorial Public Health Nutrition DirectorsJune, 2004

Health Resources And Services Administration

Maternal And Child Health Bureau

Peter C. Van Dyck, MD, MPH


Mch bureau

MCH BUREAU

LEADERSHIP


Mchb strategic plan goals

MCHB Strategic Plan Goals

  • Provide National Leadership for Maternal and Child Health by creating a shared vision and goals for MCH, informing the public about MCH needs and issues, modeling new approaches to strengthen MCH, forging strong collaborative partnerships, and fostering a respectful environment that supports creativity, action, and accountability for MCH issues.


Mchb strategic plan goals1

MCHB Strategic Plan Goals

  • Eliminate health disparities in health status outcomes, through the removal of economic, social and cultural barriers to receiving comprehensive timely and appropriate health care


Mchb strategic plan goals2

MCHB Strategic Plan Goals

  • To assure the highest quality of care through the development of practice guidance, data monitoring, and evaluation tools; the utilization of evidence-based research; and the availability of a well-trained, culturally diverse workforce


Mchb strategic plan goals3

MCHB Strategic Plan Goals

  • To facilitate access to care through the development and improvement of the MCH health infrastructure and systems of care to enhance the provision of the necessary coordinated, quality health care


The mch budget for 2003 and 2004 millions

The MCH Budget for 2003 and 2004(millions)

FY2003

FY2004(PB)

  • MCH Block Grant1…$730.0…...$750.8

    • State Block Grant….…$599.0……….$622.4

    • SPRANS(General).…..$105.7………..$109.1

    • CISS………………..….…$ 15.9………..$ 19.3

    • SPRANS(Earmark).....$ 9.4…….....$ 0.0

1-numbers will not add due to rounding


The mch budget for 2003 and 2004 millions1

The MCH Budget for 2003 and 2004(millions)

FY2003

FY2004(PB)

  • Healthy Start……………..…$ 98.3…………...$ 98.7

  • Hearing Screening…….….$ 9.9……….….$ 0.0

  • EMSC…………………….….…$ 19.4………..….$ 18.9

  • Poison Control Center…...$ 22.4………..….$ 21.2

  • Trauma/EMS…………………$ 3.5 ….…...…$ 0.0

  • AbEd Community…….…….$ 54.6…….…….$ 73.0

  • AbEd State……………….…..$ 50.0…….…….$ 50.0

  • Bioterrorism………………….$ 514.6…………..$ 518.1

  • Traumatic Brain(TBI)*…..$ 9.4……….….$ 7.5


Mch bureau1

MCH BUREAU

PROGRAM STRENGTHS


Mchb program strengths

MCHB Program Strengths

  • Genuine partnership between federal government, states, and communities

  • Statement of priorities consistent with the healthy people 2000 and 2010 goals

  • Commitment to both federal and state financing evidenced by match of 4 federal to 3 state dollars


Mchb program strengths1

MCHB Program Strengths

  • 5 year needs assessment planning

  • Framework that targets states’ expenditures to the entire MCH population--infants, children, adolescents, women, pregnant women, CSHCN


Mchb program strengths2

MCHB Program Strengths

  • Flexibility for states’ to tailor programs

  • Commitment for coordination with all other major children’s programs--idea, WIC, medicaid, SCHIP, nutrition, headstart, early intervention


Association of state and territorial public health nutrition directors june 2004

CORE PUBLIC HEALTH SERVICES

DELIVERED BY MCH AGENCIES

DIRECT

HEALTH CARE

SERVICES

(GAP FILLING)

Examples:

Basic Health Services and Health Services for CSHCN

MCH

CHC

EPSDT

SCHIP

ENABLING SERVICES

Examples:

Transportation, Translation, Outreach, Respite Care,

Health Education, Family Support Services, Purchase of

Health Insurance, Case Management, Coordination with

Medicaid, WIC and Education

POPULATION--BASED SERVICES

Examples:

Newborn Screening, Lead Screening, Immunization, Sudden Infant Death

Counseling, Oral Health, Injury Prevention, Nutrition and Outreach/Public Education

INFRASTRUCTURE BUILDING SERVICES

Examples:

Needs Assessment, Evaluation, Planning, Policy Development, Coordination,

Quality Assurance, Standards Development, Monitoring, Training, Applied Research,

Systems of Care and Information Systems


Mch bureau2

MCH BUREAU

ACCOUNTABILITY


Mch bureau performance measurement system

MCH Bureau Performance Measurement System

PRIORITIES

AND GOALS MCHB

MCHB

PROGRAM AND RESOURCE

ALLOCATION

MCHB

PERFORMANCE

MEASURES

MCHB

OUTCOME

MEASURES

MCHB

NEEDS ASSESSMENT

HEALTH STATUS

INDICATORS

PERINATAL

MORTALITY

STATE

BLOCK

GRANT

STATE/

NATIONAL

INDICATORS

I. DECREASE

DISPARITIES

INFANT

MORTALITY

DIRECT

HEALTH

SPRANS

HEALTHY

PEOPLE

2010

NEONATAL

MORTALITY

II. INCREASE

QUALITY

ENABLING

SERVICES

HEALTHY

START

POSTNEONATAL

MORTALITY

LEGISLATIVE

PRIORITIES

POPULATION

BASED

EMERGENCY

SERVICES

FOR CHILDREN

CHILD

MORTALITY

III. IMPROVE

INFRASTRUCTURE

PARTNERSHIPS

INPUT

TRAUMATIC

BRAIN

INJURY

INFRASTRUCTURE

SERVICES

INFANT

DEATH

DISPARITY


Title v sprans performance measurement system

Title V SPRANS Performance Measurement System

SPRANS

NEEDS ASSESSMENT

HEALTH STATUS

INDICATORS

SPRANS

PRIORITIES

AND GOALS

SPRANS

PROGRAM AND RESOURCE

ALLOCATION

SPRANS

PERFORMANCE

MEASURES

SPRANS

OUTCOME

MEASURES

PERINATAL

MORTALITY

DSCSHCN

STATE/

NATIONAL

INDICATORS

I. DECREASE

DISPARITIES

INFANT

MORTALITY

DIRECT

HEALTH

DCAFH

HEALTHY

PEOPLE

2010

NEONATAL

MORTALITY

II. INCREASE

QUALITY

ENABLING

SERVICES

DRTE

POSTNEONATAL

MORTALITY

LEGISLATIVE

PRIORITIES

DPSWH

POPULATION

BASED

CHILD

MORTALITY

DSCH

III. IMPROVE

INFRASTRUCTURE

PARTNERSHIPS

INPUT

INFRASTRUCTURE

SERVICES

ODIM

INFANT

DEATH

DISPARITY


Criteria for selecting performance measures

Criteria For Selecting Performance Measures

  • Relevant to state Title V activities

  • Understandable to policy makers and the public

  • Process and capacity measures should link to the outcome measures


Criteria for selecting performance measures1

Criteria For Selecting Performance Measures

  • Measurable change expected within 5 years

  • Consideration for measures which are prevention focused

  • Data generally available from majority of state


The 18 national performance measures

The 18 National Performance Measures

  • 10) The rate of deaths to children aged 1-14 caused by motor vehicle crashes per 100,000 children.

  • 11) Percentage of mothers who breastfeed their infants at hospital discharge.

  • 12) Percentage of newborns who have been screened for hearing impairment before hospital discharge.


The state performance measures keyword search

The State Performance Measures—Keyword Search

  • Nutrition/Physical activity

    • 34 States with 49 performance measures

  • Obesity

    • 19 States with 20 performance measures


The 9 health systems capacity indicators

The 9 Health Systems Capacity Indicators

  • 09C) The ability of States to monitor overweight or obesity among children and youth (as reported in the 2002 Annual Block Grant Report)


The 9 health systems capacity indicators1

The 9 Health Systems Capacity Indicators

  • YRBS

    • 51 of 59 States participate

    • 36 (61%) sample size is large enough for statewide estimates

    • 15 (25%) sample size too small

    • 8 (14%) do not participate


The 9 health systems capacity indicators2

The 9 Health Systems Capacity Indicators

  • Pediatric Nutrition Surveillance System

    • 40 of 59 States participate

    • 35 (59%) sample size is large enough for statewide estimates

    • 5 (9%) sample size too small

    • 19 (32%) do not participate


The 9 health systems capacity indicators3

The 9 Health Systems Capacity Indicators

  • WIC Nutrition Survey

    • 54 of 59 States participate

    • 49 (83%) sample size is large enough for statewide estimates

    • 5 (9%) sample size too small

    • 5 (9%) do not participate


The 37 discretionary performance measures

The 37 Discretionary Performance Measures

  • 08) Percent of graduates of MCHB long-term training programs that demonstrate field leadership after graduation

  • 33) The degree to which a State system for nutrition services has been established for MCH populations


The children s health survey

The Children’s Health Survey

  • Height and Weight

  • Food allergy or digestive problem

  • Breast feeding(0-5)

  • How concerned are you about eating disorders(6-17)


Association of state and territorial public health nutrition directors june 2004

MCHB’s

ERP

Printed Reports

Electronic search

Across States and Years

and retrieval

Title V IS

State

ERP

Automated updating

Automated search

and error checking

and sorting

Printed Forms

Title V Information System

Data

Data

Other Data Sources

Database Searches

on the Internet


F ocus area 19 nutrition and overweight progress review

Focus Area 19:Nutrition and OverweightProgress Review

January 21, 2004


Impact of nutrition and overweight on the health of americans

Impact of Nutrition and Overweight on the Health of Americans

  • Dietary factors are associated with 4 of the 10 leading causes of death (CHD, some types of cancer, stroke, and type 2 diabetes)

  • These diet-related conditions are estimated to cost society over $200 billion annually in medical expenses and lost productivity

  • Dietary factors are associated with osteoporosis, which affects over 25 million persons in the U.S.


Association of state and territorial public health nutrition directors june 2004

Improving

Getting worse

Little or no change

Cannot assess (limited data)

Nutrition and Overweight

Objectives

Weight Status and Growth

Iron Deficiency and Anemia

Healthy weight in adults

Obesity in adults

Overweight or obesity in children

and adolescents

Growth retardation in children

Iron deficiency in young children and in

females of childbearing age

Anemia in low-income pregnant females

Iron deficiency in pregnant females (dev.)

Schools, Worksites, and Nutrition Counseling

Food and Nutrient Consumption

Fruit intake

Vegetable intake

Grain product intake

Saturated fat intake

Total fat intake

Sodium intake

Calcium intake

Meals and snacks at school (dev.)

Worksite promotion of nutrition

education and weight management

Nutrition counseling for medical

conditions

Food Security

Food security


Association of state and territorial public health nutrition directors june 2004

Highlighted Objectives

19-1. Healthy weight in adults

19-2. Obesity in adults

19-3. Overweight or obesity in

children and adolescents

19-5. Fruit consumption

19-6. Vegetable consumption

19-7. Grain consumption


Trends in child and adolescent overweight

Trends in Child and Adolescent Overweight

Percent

Percent

Males 12-19

Males 6-11

Females 12-19

Females 6-11

1963-67

1971-74

1976-80

1988-94

1999-2000

1966-70

Note: Overweight is defined as BMI >= gender- and weight-specific 95th percentile from the

2000 CDC Growth Charts for the United States.

Source: National Health Examination Surveys II (ages 6-11) and III (ages 12-17), National

Health and Nutrition Examination Surveys I, II, III and 1999-2000, NCHS, CDC.

Obj. 19-2


Association of state and territorial public health nutrition directors june 2004

Child and Adolescent Overweight

by Race: 1988-94 to 1999-2000

2010 Target

1988-94

Total

White

Black

Mexican

American

Female

Male

0 10 20 30

Percent

Note: Overweight is defined for ages 6-19 years as BMI >= gender- and weight-specific 95th percentile from the 2000 CDC Growth Charts for the United States Black and white exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race.

Source: National Health and Nutrition Examination Survey, NCHS, CDC.

Obj. 19-3c


Association of state and territorial public health nutrition directors june 2004

Fruits and Vegetables: Average Number

of Daily Servings by Race: 1999-2000

White

Black

Mexican American

Average number of servings

Total

Minimum Recommended

Vegetables

Fruits

Note: Data are age-adjusted to the 2000 standard population for ages 2 years and over. Black and white exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race.

Source: National Health and Nutrition Examination Survey, NCHS, CDC.

Objs. 19-5

19-6


Association of state and territorial public health nutrition directors june 2004

Fruit Consumption by

State, 2002

D.C.

N

Proportion with 2+ fruit servings a day

(14)

(17) (20)

25.0% +

20.0 -24.9%

<19.9%

Note: Data are for ages 18 years and over.

Source: Behavioral Risk Factor Surveillance System, NCCDPHP, CDC.

Obj. 19-5


Proportion of vegetable servings 1999 2000

Fried

potatoes

Fried

potatoes

22%

Other

46%

Tomatoes

potatoes

11%

13%

Tomatoes

Legumes

Other

Dark green/

9%

8%

potatoes

orange

10%

Legumes

Dark

11%

6%

All others

All others

green/

22%

35%

orange

8%

Proportion of Vegetable Servings 1999-2000

Children 2-19 years

Adults 20 years and over

Target = At least 1/3 dark green/orange

Note: Data are age adjusted to the 2000 standard population for adults 20 years and over.

Source: National Health and Nutrition Examination Survey, NCHS, CDC.

Obj. 19-6


Proportion of grain servings 1999 2000

Proportion of Grain Servings 1999-2000

Children 2-19 years

Adults 20 years and over

Target = 1/2 whole grain

Note: Data are age adjusted to the 2000 standard population for adults 20 years and over.

Source: National Health and Nutrition Examination Survey, NCHS, CDC.

Obj. 19-7


Important information

Important Information

  • All grantee meeting--October 3-6

  • Child Health Day--October 4

  • CSHCN survey ‘easy’ web site

    • WWW.CSHCNDATA.ORG

  • Stopbullyingnow.hrsa.gov


Contact information

Contact Information

Peter C. van Dyck, MD, MPH

[email protected]

Data Site

https://performance.hrsa.gov/mchb/mchreports


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